What Is an IME in Minnesota Workers' Comp?

An IME ("independent medical examination") is an exam by a doctor the insurance company picks and pays. Calling it independent is not accurate. It is the insurer's medical evaluation of your claim, authorized by Minn. Stat. § 176.155, and its report is the single most common foundation for stopping benefits or denying care in Minnesota claims. The exam is not set to help your doctors find a better or more effective treatment plan. It is set with the goal of denying benefits.

Getting scheduled for one isn't a crisis yet, but it is a signal. Insurers rarely spend money on an IME for a claim they expect to keep paying.

Why the insurer scheduled it

Most IMEs are ordered to get one of a few opinions: that you've reached maximum medical improvement (MMI), that you can work without restrictions (which sets up a NOID, explained in what a NOID is), that a recommended surgery or treatment isn't reasonable and necessary, that your problem is degenerative or pre-existing rather than due to the work injury, or that your PPD rating should be lower than the one your treating doctor gave.

Your rights around the exam

The exam must be at a time and place reasonably convenient to you, and your travel expenses are reimbursable. The statute also requires the exam to be scheduled within 150 miles of your home unless the insurer shows cause to the Office of Administrative Hearings for a farther location. If the insurer is trying to set one farther away than that, it is a very clear signal that they are going to cut off your benefits. The only reason an insurer would pay for your travel on top of paying the doctor is that they know the doctor they are paying extra for you to see will say exactly what the insurer wants.

Attendance at a properly set IME is effectively required. Unreasonably refusing a properly noticed exam can suspend your benefits. If the scheduling genuinely doesn't work, the answer is to get it moved, not to skip it. If you skip an IME, the insurer will very likely try to cut off your wage-loss benefits, and it may stop approving your medical treatment too.

At the exam, answer honestly and completely. Don't minimize and don't exaggerate. You don't have to volunteer your life story, but IME doctors write down inconsistencies, and so do surveillance vendors. It is common for IME doctors to watch you walk in from the parking lot, down the hallway, or through the waiting room, and to put those observations in the report. If you think exaggerating symptoms like pain, a limp, or reliance on a cane is going to help your claim, you are wrong. IME doctors are real doctors, even when they are acting as the insurer's hired gun. They will spot and point out exaggerated or inconsistent complaints. They have tests during the physical exam built for exactly that, and you will not recognize them as tests, because they are subtle enough that you may not realize which part of your body is being evaluated. So be accurate and do not exaggerate.

The reverse is also true. Do not under-report. Tell the doctor every symptom you have or have had from the work injury. Say when the symptoms come, when they go, and what makes them better or worse if you know.

You can bring a witness, and it's a statutory right. Minn. Stat. § 176.155, subd. 1(a) says you are entitled, on request, to have your own physician or an unpaid witness present at the examination. Each side pays for its own person, so the witness has to be unpaid: a spouse, a relative, or a friend. Request it in writing before the exam so there is no argument at the door.

Right after the exam, write down what happened: when it started and ended, what was physically examined, what tests were performed, and what you were asked. Note how long the exam lasted, from the moment the doctor walked in to the moment they left the room.

After the report

The report goes to the insurer and eventually to you. If it says what the insurer hoped, expect action on it (a NOID, a treatment denial, or an attempt to end your QRC services), often within weeks.

The counterweight is your treating doctor's written opinion. A compensation judge weighs both, and a one-time exam does not automatically beat months of treatment records. But that only works if your doctor's opinions on restrictions, causation, and treatment need are actually in writing in the record.

If your doctor's chart is thin, fix that before the fight starts. If you are claiming an injury caused by repetitive activity over time, make sure you have explained to your doctor exactly what you do physically at work that you think is contributing to the injury. Ask your doctor whether your work activities caused or contributed to your condition. If a surgery is being proposed, ask your doctor whether the need for it relates directly to the work injury, and ask them to explain why. Then ask whether they would put that discussion and their explanation in your chart note.

As long as your doctor has well-reasoned explanations for why your condition comes from your work activities or injury, and why the recommended treatment is both necessary and related to the work injury, your attorney can hit the ground running and will be well positioned to fight the IME when the fight starts.

Insurers also attach surveillance and social media to IME files. Do not post anything on social media that shows you doing things that obviously exceed your work restrictions.

If you have an IME set, or have already had one, call an attorney now. If you call or text me at (651) 283-8747 with the details of your claim, I can tell you the best defensive plan so you are well positioned if and when the insurer cuts off your benefits. That might mean hiring me to start gathering your medical records and other evidence, or it might just mean advising you to get your ducks in a row with your doctor. Call even if you are not ready to hire anyone. This is a critical point in your claim, and I want you to be able to talk to an attorney even if you do not want to hire one yet. If you would rather not involve a lawyer at all, the DLI help desk is free.

Keep score yourself

Whatever the IME says, know what's at stake in dollars: your weekly rate (TTD calculator), your permanency value (PPD calculator), and your overall exposure (settlement calculator). If the exam assigned a rating, check it against the PPD rules by body part. Insurers act on IMEs faster when the remaining exposure is large, and understanding that number explains a lot of adjuster behavior.